Justice News

Three Miami Residents Sentenced in Largest Medicare Fraud Scheme Loss in 2015

Three Miami residents were sentenced for their role in the largest Medicare fraud scheme loss prosecuted in the Southern District of Florida in 2015.

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, and Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Miami Regional Office, made the announcement.

Jorge Lorenzo, 36, Yahima Pardo, 33 and Roberto De Jesus Alonso, 48, all of Miami, Florida were sentenced by U.S. District Judge William Dimitrouleas to 188 months, 41 months, and 37 months in prison, respectively. The defendants were also ordered to pay $40,388,943.00 in restitution to the Medicare program. In addition, forfeiture money judgments were entered against each defendant and the government has seized assets and cash in excess of $2 million. On May 10, 2016, Lorenzo and Pardo pled guilty to conspiracy to commit health care and wire fraud, and Alonso pled guilty to conspiracy to commit money laundering.

According to the court record Lorenzo, Pardo, and De Jesus Alonso participated in massive health care fraud, money laundering and kickback schemes, that over the course of approximately four years, resulted in more than $40 million in losses to the Medicare program. During the course of the criminal conduct, Lorenzo owned and/or controlled eight home health agencies across Miami-Dade County that collectively received more than $40 million in fraudulent claim payments from Medicare. Lorenzo installed shell owners at his home health agencies whose primary role was to authorize millions of dollars in Medicare claim payments through corporate checks made out to fictitious companies staffed by other co-conspirators. The co-conspirators then laundered the fraudulently obtained money to Lorenzo. More than $40 million in Medicare payments were made in response to fraudulent claims for services that were not medically necessary, never rendered and in some instances were linked to prescriptions that Lorenzo counterfeited. Collectively, these eight home health agencies were operational for an average of only 8 months before being closed at Lorenzo’s direction at the first hint of a Medicare fraud investigation. Conspirators Pardo and Alonso, were shell owners of two of the eight home health agencies and laundered millions of dollars in Medicare claim payments to Lorenzo.

Lorenzo also directed co-conspirators to incorporate more than fifteen fictitious shell companies. The shell companies were used to disguise the flow of more than $25 million in fraudulently-obtained Medicare proceeds for Lorenzo’s personal benefit, including the purchase of real estate, luxury vehicles, artwork and jewelry. Coconspirator Alonso incorporated at least two of the fictitious companies to launder proceeds which were intended to benefit elderly, blind and disabled patients.

An additional co-conspirator, Sonmy Rodriguez, 45, of Miami, Florida, was sentenced on July 27, 2016 to 22 months in prison.

Mr. Ferrer commended the investigative efforts of the FBI and HHS-OIG. This case was prosecuted by Assistant United States Attorneys Kevin J. Larsen and Evelyn B. Sheehan.